Sickness in the health service

A former editor of this magazine, Nigel Lawson, once described the NHS as ‘the closest thing the English have to a religion, with those who practise in it regarding themselves as a priesthood’. He meant to imply that blind faith tends to take over from observation. But there are other likenesses: bickering cardinals, grandiose PFI cathedrals that suck money from the pockets of believers — and now, finally exposed after being covered up for years, a shocking scandal of abuse.

Hospital managers like to commission paintings of the premises to hang in their corridors. In the case of Mid Staffordshire Hospitals Trust, William Hogarth would have been a suitable choice of artist. If the scenes of ‘routine neglect’ exposed by Robert Francis’s report were described in a charity campaign for a developing country, it would have tens of thousands of concerned Britons stuffing tenners into envelopes.

It is now clear that this was not a unique tragedy, but an egregious example of a systemic problem: what happens when the NHS goes wrong. As Francis reveals, poor care was bred into the system, with managers and medical staff responsible for it allowed to take up jobs elsewhere in the NHS. His central recommendation — that medical staff be put under a ‘duty of candour’ to report poor care — may open a very large Pandora’s box. According to a survey by the Nursing Times, one in four nurses believes their NHS hospital is ‘at risk’ of suffering a similar scandal to Mid Staffordshire. One in eight say hospitals are already experiencing a similar collapse in the standard of care.

Even the Conservative ministers who answer every challenge to the NHS by saying that more cash than ever before is being poured into its coffers should by now realise that this is not a question of money, but of organisation.